The insiders

Doctors who inject pethidine, lawyers who can't get through the day without a drink and housewives addicted to prescription drugs. For $13,000 a month, Warburton Unit treats them all. Liz Porter reports.

On a Saturday night, a group of youngish
people is sprawled on sofas and chairs
watching a video in the large, highceilinged
front parlour of a grand Victorian
mansion. 28 Days is on, with Sandra Bullock
doing her star turn as the heavy-drinking bridesmaid
who is packed off to rehab after falling headfirst
into the cake at her sister's wedding.

The room is furnished for comfort, with floorlength
tomato velvet curtains, soft green couches
and inviting-looking armchairs upholstered in
gold-threaded silk. A small collection of board
games, including Scotland Yard and Trivial Pursuit,
is piled near a picture window overlooking a
garden planted with towering tropical date palms.

There's a sudden burst of laughter as a glowering
Bullock, newly arrived in rehab, has her mobile
phone confiscated by the bossy boots head nurse.
But there's an edge to the mirth. These relaxed-looking
adults may look like a group of dresseddown
city professionals enjoying weekend R&R in
a country house hotel. But in reality, they're a
group of dressed-down city types doing a 28-day
spell in rehab in suburban Ivanhoe.

Comic exaggerations aside, their daily program
bears more than a passing resemblance to the routine
at Sandra Bullock's fictional establishment.

There's the same rule forbidding mobile phones.
The same prison-style search of luggage on arrival.

The same group therapy sessions and rules about
saying what you "feel", not what you "think".

This clinic is a last resort for people like Ray, a
53-year-old lawyer, who experienced a "moment of
truth" a few days before Christmas Day 2002, when
he woke up with his first-ever episode of "the
shakes" after drinking his way through the "six,
seven or eight" bottles of wine that were sitting,
wrapped in gift paper, under the Christmas tree.

"My wife was on the verge of kicking me out,"
he recalls. As he sat on the floor of his loungeroom,
shaking too hard to hold a glass of water, he
realised he needed something much more drastic
than yet another stay in a hospital detox unit.

"There is no touching. People need to know they can recover on their own. Needing to hug someone is usually about you, not them." Anita Dickson, nurses' unit manager and counsellor

He
had heard about Warburton from a client who'd
gone there and emerged "looking completely different".

He'd also heard that the regime was "a
combination of Alcatraz, Stalag 13 and Pentridge".
Suddenly he was desperate to go there.

A problem drinker for 25 years, Ray had done
detox twice. He spent months in hospital in 1989
after an alcohol-related collapse (and didn't drink,
except for a couple of brief binges, for 10 years.)

"I could go without a drink for weeks, then
have one at 7am," he says. Now, he has been clean
for 14 months.

The Warburton Unit, as it's known, is the
Australian equivalent of America's Betty
Ford Clinic or London's The Priory. Originally
based in the Yarra Valley, it was relocated
to Ivanhoe last year.

Like the Ford Clinic, Warburton is a 12-step
program based on group support, attendance at
Alcoholics Anonymous, Narcotics Anonymous or
Gamblers Anonymous meetings, and life-long
abstinence. The 12 steps refer to the stages of
growth a person must move through to achieve
and maintain sobriety.

The 220 people who went though the unit last year included alcoholics, drug addicts, compulsive
gamblers and a few "sex addicts", with all age
groups represented. On one of the days
The Sunday Age visits, for example, there are 12 inpatients
 three in their 20s, and half a dozen in
their 30s. Only three have nominated "alcohol" as
the only drug they have been abusing. Only one, a
user of heroin and amphetamines, doesn't drink.
The rest have combination drug-use patterns 
from "LSD and marijuana, combined with binge
drinking", to "alcohol and heroin".

The 28-day program, which can take up to 19
patients at a time, costs $13,100, a fee which is
rebatable only by private health funds. Not surprisingly,
the clientele is predominantly middle-class,
although despairing families without health cover
occasionally raise the full amount in a last-ditch
rescue effort for a relative.

Doctors are regular in-patients, as are lawyers,
nurses, senior managers, police officers, teachers,
social workers, tradespeople  and the black-sheep
adult children of wealthy Melbourne families.

There is also the odd minister of religion, the
occasional client on a court order requiring him or
her to get clean or go to jail  and sometimes a
judge from interstate, seeking a discreet solution
for a drinking problem.

"Last year we had about a dozen doctors," says
George Thompson, a part-time counsellor and former
manager of the clinic from 1991-1998.

"Alcohol was the majority's problem. But there
were two with pethidine problems." Their drug
use had been noticed by colleagues in the workplace,
he says.

Thompson himself is a former alcoholic (or
"recovering", as he prefers to put it) and is never
surprised by the regular presence of high-achieving
professionals at Warburton.

"The addict may be the best performer, the best
worker. They are people-pleasers  driven, obsessive,
perfectionist. They might be top performers,
but they take Mondays off."

Doctors having treatment at the clinic tend to
be referred by Dr Jack Warhaft, who runs the Victorian
Doctors' Health Program, a confidential
referral and advisory service set up for doctors facing
drug and alcohol problems.

Some doctors seek his help because a confidential
in-house report of their drug use has been
made by a theatre nurse or other medical colleague.

Others come in after their substance abuse
has brought them to the attention of the Medical
Practitioners Board, which may suspend them
until they have recovered.

"It is simply intolerable for doctors to be using
drugs while they're working; theyre like airline
pilots in this respect," says Dr Warhaft. "If they
come to treatment quickly, recover, undergo regular
monitoring, including chemical monitoring,
and demonstrate they are 'clean', they can avoid
being reported."

"They have a lot more to lose than somebody
who has been unemployed, particularly if their job
is under stress. The success rate for doctors is phenomenal.
The fact that they're likely to lose their
profession if they don't improve is the incentive.

"It is amazing how well people can keep (an
addiction) from their workmates and families,
holding things together when the work situation or spouse demands it." Single professionals living by
themselves often keep a drug addiction secret if
they only use at home.

"We've also had a significant number of housewives,
who have a prescription drug habit that
their spouse doesnt know about."

Anonymity and confidentiality are among the
Warburton clinic's many rules, with residents
required to introduce themselves only by first
names  and to wear their name tags, because
new patients arrive most days.

Although there are security gates, high fences
and video cameras around the unit, patients can
walk out any time they like. The security is there to
stop "friends" coming in with drugs or alcohol.

"They come from all walks of life," says Sue
Hewat, the clinic manager and director of nursing.

"But grief and loss are common threads. In some
instances, marriages have broken down. Some
have lost their jobs and their homes  some have
burned all their bridges."

Tonight the residents are relaxing in front of
TV because it's Saturday night, one of the few
"free" slots in a timetable jammed tight with
group therapy, individual counselling sessions,
lectures, educational videos, and nightly attendance
at AA, NA and Gamblers Anonymous meetings
all around Melbourne. The only
non-educational videos available to them are chosen
from a small collection which includes The
Castle, Beaches and Tuesdays With Morrie, all either
inspiring, amusing or soppily sentimental, with
no content likely to stir up desires for intoxication.

Otherwise, TV is limited to a 30-minute 6pm
glimpse of the evening news.

"We don't want people using TV shows as
escapism," says Anita Dickson, who manages the
nurses' unit and helps run the daily group therapy
sessions.

New arrivals can bring only one book. Mobile
phones, laptops, radios and CDs are not allowed.
Nor are vitamins, herbs, mouthwash (it contains
alcohol) or footy tipping. Five-minute phone calls
are allowed only after the first seven days, and
between 5pm and 11.30pm. Residents do their
own laundry and clean their own rooms.

Sitting in her comfortable family room, with
its photos of her three children beaming
from the deck of the family yacht, Hannah,
46, a critical care nurse, is dredging
through painful recollections of the day she was
admitted to Warburton in April 2003.

She recalls watching the nurse locking doors.
"You just can't believe this is happening to you.
You think 'How on earth did I get here?'
"The kids were looking after themselves," she
says. Her youngest child's first day at school? No
memory of it. Her middle child would have been
looking after him, she says. Meanwhile the kids'
tennis and swimming lessons had ceased because
she was too drunk to remember to pick them up.

Once a "strictly social" drinker, Hannah had
begun some daytime drinking at lunches 13 years
ago when she was on her first maternity leave. A
competent manager with a graduate diploma in
health administration, she'd managed several hospital
care units. But five years ago, she was unhappy
working as a part-timer under a boss she didn't
like, and she began having a few glasses of wine
when she came home from night shift, as she got
the children ready in the morning.

"I'd say I was having my dinner," she recalls.
Soon her burgeoning addiction and her battle to
hide it had taken over her life. She remembers
playing tennis in a stumbling haze (with her water
bottle full of wine). Her husband had taken her
credit cards to stop her buying booze, but every
room in the house had its secret alcohol stash
(wine cask bladders were hidden in the laundry, in
pillow cases, in the grandfather clock; the front garden
was seeded with full beer bottles.)

"I was getting up at 3am to have a drink to stop
the shakes and the sweating."

Hannah had already done two Melbourne Clinic
detoxes before Warburton. On the way home
from the second detox she bought cans of vodka
and orange  "so no one would smell them" 
because she felt so ill.

"I was physically sick and shaking. I said 'I can't
do this anymore'."
Her husband drove her back to the clinic. "They
said '28 days at Warburton'. I said 'OK'."

Some new Warburton in-patients arrive drunk
or stoned (having had one last taste of their
favourite poison before leaving for the first day of
the rest of their new life).

Hannah recalls desperately "necking" two bottles
of low-alcohol beers while she packed and her
husband was in the study.

Patrick, a financial planner whose GP suggested
his deep depression was alcohol-fuelled,
marked his last Saturday night before Warburton
with a dinner party at which he served the best
wines from his long-nurtured private cellar.

Did he get drunk for one last time? He laughs.
"I got drunk every time I drank. The term is
'functioning alcoholic'. I still had my career, my
family, I still had one or two alcohol-free days a
week. At dinner parties I had to watch my drinking
so as not to make a dickhead of myself. I had never
shied away from the realisation that I was an alcoholic.
I gave it up for 12 months when I was 23 so
I could start my accountancy degree. Until Warburton
I didn't realise that it was a disease  and a
progressive disease that was going to get worse."

In the Warburton unit's nurses' station, Anita
Dickson glances at a sign on a noticeboard:

"Even when a decision is not negotiable, please
give the clients the respect of being heard."

She grins. On admission, clients sign a contract
in which they consent to a whole array of nonnegotiable
decisions, such as having their bags and
pockets searched at any time or having breathalysers
and urine tests "at staff discretion".

"These people have been going by the beat of
their own drum for so long that they find it hard.
But they do need to have a chance to bitch and be
heard."

Hannah, for example, remembers her outrage
at being searched, and then, on day four, after her
withdrawal symptoms had eased, being denied a
Valium.

"I woke up and I needed my valium. The nurse,
I thought she was a real witch, took my blood pressure
and said 'You don't need it. You just go for
your walk with a smile on your face, get your
endorphins going, and you won't need any valium.'

"I slammed my fist down on the desk. But I
walked, and got my endorphins going  and I
haven't had a Valium since."

Outside the nurses' station, a brick-paved courtyard
is furnished with a circle of chairs and a barbecue.
One resident has made himself a
hamburger from the buffet of food laid out in the
kitchen and is sitting out there eating it. Over his
head, a segmented wooden sign hangs from a pergola
post, reminding passers-by that "Today is the
tomorrow you worried about yesterday."

A few others patients are eating at tables in the
large light-filled kitchen, where one noticeboard is
decorated with inspirational quotations from Nelson
Mandela and reminders to "clean up after
yourself". Nearby someone has posted their
"thought for the day": "It's a beautiful thing/The
sun comes up/I'm having a good day."

It's 10.30am Friday. Time for art therapy. The
residents have already taken their daily 8am
walk, attended a 9.15am meditation session
then farewelled a patient who has just finished
his 28 days.

Piano music fills the art therapy room as a
dozen residents sit at a long table working with
paints and crayons. Today's theme is "belief" and
the work is bright and graphic. A yellow hand. A
red heart. A rainbow.

By 2pm the front area of the mansion is quiet.
Another session is taking place. "Group is in
progress," reads the sign on one door. "Silence
required."

Inside that room, a chart on the wall spells out
the famous "12 steps" towards sobriety. Another,
headed "How are you feeling today?" displays a list
of cartoon facial expressions with captions ranging from "confused" and "exhausted" to "depressed",
"hysterical" and "smug".

Patients here have difficulty working out how
they're feeling, explains Dickson.
"In the past they have always medicated their
feelings (away)," she says.

Every group session is different, the counsellor
says. Firstly, the composition changes as new
patients join and existing ones move through the
different stages of their stay.

Different professions also behave in certain ways
in a group. "Policemen tend to get really angry
when they hear (while others are telling their life
stories) that someone's been abused," says the counsellor.

"Doctors and nurses try to look after people
and give advice." But this is not allowed. People
have to speak about their own experiences in group,
starting sentences with 'I'. And the lawyers sometimes
try to take the floor too much. They also need
to be pulled into speaking in the first person, rather
than saying 'we' and remaining general.

"It's about what is going on internally for people.
They work on their feelings. Where is their
fear coming from? Where is their anger coming
from? The purpose is learning about yourself, and
yourself as seen by others. Most hurts are about
our relationships, so the group is a hot-house of
emotions.

"I always tell people 'It is normal to feel scared,
but the group is where you will learn most'. I tell
(clients) 'You will have emotions in there that you
have medicated yourself to stop feeling'."

There are often tears in the group, but no hugs.
"There is no touching. People need to know
they can recover on their own. And needing to hug
someone is usually about you, not about them."

Seven days into their stay, each patient has to
give the group a 20- minute summary of his or her addiction history and its consequences. Then, after
14 days, each patient has to face up to a "peer
review" where the rest of the group evaluates his or
her progress. Group sessions, recalls Ray, were
"terrifying".

One counsellor (whom he credits with saving
his life) continually confronted him for "intellectualising".

"She'd say: 'Everything that comes after "but" is
bullshit'. And 'however' is just another word for
'but'. I've got a massive ego and I'm full of bullshit
and bravado, but it's just a massive defence mechanism.
Around days 10, 11, 12, my fear of group left
me. I got to the stage where I was prepared to
admit that I felt angry."

The group sessions also helped teach Hannah
to cope with social situations without alcohol.
"Before, I was very confident with a few glasses
under my belt. And I remember thinking, 'I'm
glad I'm in my 40s doing this'. I remember there
was a young woman who'd been into drugs since
her late teens and who'd been a prostitute."

Inevitably some residents fail to stick out their
28 days and some are asked to leave after being
caught smuggling in drugs.
But a successful recovery doesn't just mean
completing a 28-day stint in the unit. All residents
complete an "aftercare" program, which involves
weekly attendance at a Monday night "aftercare"
meeting in Box Hill and regular attendance at AA
or NA meetings.

Ray goes to five a week. Patrick goes to two,
Hannah to two or three.
"And it's so nice to go to aftercare every Monday
night and see everybody getting better and better,"
says Hannah, who will soon join Ray and Patrick,
in the successful 54 per cent of Warburton graduates
who are still clean after their first year.

Of the 46 per cent who relapse in the first year,
says George Thompson, most will have another go
at the program. Of those, just over half will be
clean a year later, bringing the overall success rate
past 70 per cent.

Jane, 36, a former drug addict and alcoholic, is
one of those success stories. Now mother to a
three-year-old, she recently celebrated the sixth
anniversary of her stay at Warburton, and still goes
to NA meetings three times a week.

"Rehab provides you with a set of tools to live
life as a clean and sober person," she says. "But
you need to align yourself with AA or NA to live
that life."

The daughter of a wealthy Melbourne family,
Jane admits she was a "spoiled rich kid" who went
to a private school, and completed a science degree
while cultivating a taste for weekend binge drinking
and dope smoking. After a doctor friend introduced
her to morphine, she graduated to heroin,
which she could manage to combine with a job in
a lab, because she worked night shift. She financed
her habit by stealing her mother's jewellery and
committing fraud on her own and her family's
trust account.

Looking back, she remembers Warburton as
horrendous and life-saving. In the group, she had a
terrible time "for being a poor little rich girl".

"All the counsellors could see right through
me," she recalls. "The Warburton program will
work for anyone who wants it to work. But you
have to be ready."

On a sunny weekday morning, Hannah
stands in her driveway, where a tree still
bears the marks of the day she drunkenly
attempted to back down the drive in the
family Mercedes, in the rain.

She celebrated her 100th day of sobriety last
year with a family trip to Uluru.
"I climbed the rock," she laughs  with water,
not wine, in her water bottle. She's back at work as
an agency nurse and happy to be a sober person in
the room at parties.

But her eyes fill with tears as she recalls the
anguished look on her children's faces when they
saw a waiter hand her a complimentary glass of
champagne at a holiday cocktail party (they didn't
realise that she'd agreed to take it for her husband).

"I'll never put them through that again," she
says. "I couldn't do it to them."